On July 31, 2019, Pennsylvania Governor Tom Wolf issued an executive order focused on developing further support for home- and community-based services (HCBS). The governor directed state agencies to pursue “bold reductions” in institutionalization of children and adults, and transition them to HCBS in conjunction with reducing placements in child residential treatment facilities, nursing homes, and child congregate care settings. In Executive Order 2019-05: Protection Of Vulnerable Populations, the governor further directed state agencies to strengthen oversight and implement policies to increase accountability, and establish new policies to address the impact of trauma. It also directs state agencies . . .